The 26-year-old Phoenix resident has gone the past four years without health insurance, using clinics and the county hospital for checkups, routine tests and visits to a gynecologist. She pays cash, checks prices and tries to go when doctors are offering discounts.

Helena Gudger, 26, pauses as she works on homework while taking a break between classes at her college in Phoenix on Tuesday, Sept. 10, 2013. The 26-year-old Phoenix resident has gone the past four years without health insurance, but wants to sign up for private health insurance as soon as the new federal marketplace opens in October. (AP Photo/Ross D. Franklin)

But she also is aware that she will be in a lurch if she gets sick. She does her best to avoid crowds where she could pick up an infection and even researches the local lake for outbreaks when her friends plan an outing. She wants to sign up for private health insurance as soon as the new federal marketplace opens in October.

“I know I have to plan ahead with certain events. I try to avoid crowded places where a lot of exchange of germs may transpire — I don’t want to get sick,” Gudger said. “It definitely makes you more aware of your surroundings. It’s a constant factor in the back of your mind.”

Insurance companies need young, healthy adults to buy insurance because new mandates under the federal health care reforms mean they can no longer turn away people with pre-existing medical conditions or charger older people much higher premiums.

They now must offer policies to everyone, no matter their health, and face limits on prices for older customers.

The twentysomethings and those in their early 30s who are most coveted by the insurance industry have a difficult decision to make as the health insurance exchanges begin accepting enrollment in October: Should they pay the $100 annual penalty for not having insurance or pay monthly premiums for coverage that might have high deductibles and out-of-pocket expenses?

Some six million people of various ages will pay the tax penalty for not having insurance next year, the Affordable Care Act’s first full year of implementation, according to the Congressional Budget Office.

Some younger people argue they don’t need insurance and will opt to pay the penalty, although by 2016 the fine jumps to $695 a year or 2.5 percent of taxable income, whichever is more.

Gudger said she is not in that category. A student at two-year Phoenix College who hopes to eventually earn a four-year environmental science degree, she just started a $13-an-hour, part-time job for a company selling solar panels. She has spoken with her mother about how the law will help her get insurance.

But she has little information about how the new federal marketplace — Arizona chose not to run a state program — will work, let alone the exact coverage the plans might provide. And while she may qualify for insurance through her employer in six months, that’s a long way off for her and she wants to know her options now, and for the future.

“What I know is pretty much I believe in the next year or so everybody’s going to have health care, whether you have kids or not,” she said. “Everybody needs to have health care in some form or another.”

Based on her income, Gudger will qualify for federal subsidies that will pay nearly half the premium for a midpoint “silver” plan, which covers 70 percent of costs and includes co-pays. An online calculator created by the Kaiser Family Foundation estimates her annual premium at $3,163 and the federal subsidy at $1,434, leaving her with a premium of $1,729, or $144 a month.

Even with the federal subsidies, that estimated cost is higher than what she hoped to see. And because she wants a decent insurance policy, not the bare-bones coverage cheaper plans offer, she’s still not sure just how she’ll proceed.

“If I was to be able to be offered affordable health insurance, I would say I would probably afford anywhere between $60 and $100 a month,” Gudger said. “I wouldn’t want to pay more than $75, considering I’d have to pay for prescriptions and copays if I have to see a doctor.”

Top Headlines - News

Last week, Hanover was a wintry wonderland. The county was blanketed with several inches of snow all over. As a result, students were knocked out of school for four days because of the inclement weather and will have to make up at least one day of school.

Concerned students have banded together to form "Hanover Students for Freedom of Information and Learning" in response to the school board's decision to restrict students' access to "controversial" instructional materials.

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Headlines of the Day

Top Headlines - News

Last week, Hanover was a wintry wonderland. The county was blanketed with several inches of snow all over. As a result, students were knocked out of school for four days because of the inclement weather and will have to make up at least one day of school.

Concerned students have banded together to form "Hanover Students for Freedom of Information and Learning" in response to the school board's decision to restrict students' access to "controversial" instructional materials.

Top Headlines - Sports

The Yellow Jackets have not only broken the school record for most consecutive wins, now at 20 and counting, but they completed their first perfect regular season in Old Dominion Athletic Conference (ODAC) play at 16-0 with an 82-63 win Saturday at Emory and Henry.

Saturday, the Yellow Jackets knocked out Bridgewater 87-75 to give Randolph-Macon their 20th win of the season. The Yellow Jackets finished second in the Old Dominion Athletic Conference with a 13-3 mark. Randolph-Macon is the number-two seed in this week’s ODAC Tournament in Salem.

Top Headlines - Lifestyles

One 16-year-old’s future plans changed after watching a documentary. Sydney Tinker, a junior at Patrick Henry High School, watched the film “Girls Rising,” which shares the story of several young girls in impoverished countries and how they overcome the struggles of their daily lives. It not only pulled on her heart strings, but it also sparked something in her.

One of the county’s first reserve deputies continues to volunteer his time helping Hanoverians in need and working alongside paid law enforcement in the field fighting crime. For as long as the unit has existed, Lt. Wayne Pugh has worked as one of the Hanover Sheriff’s Office’s reserve deputies, who serve the department just as a career officer would. He said he was one of the first five officers when the department first started the reserves program in 1979.